Single-lead percutaneous peripheral nerve stimulation for the treatment of hemiplegic shoulder pain: a case series.

Abstract

OBJECTIVE:

Previous studies demonstrated the efficacy of Intramuscular Nerve (IMN) therapy with a 4-lead percutaneous, peripheral nerve stimulation (PNS) system in reducing hemiplegic shoulder pain (HSP). This case series investigates the feasibility of a less complex, single-lead approach in reducing HSP.

METHODS:

Eight participants received one percutaneous intramuscular lead in the hemiparetic deltoid muscle and were then treated 6 hours/day for 3 weeks. The primary outcome measure was the Brief Pain Inventory (Short-Form) Question 3 (BPI3), which queries worst pain in the last week on a 0 to 10 numeric rating scale. Secondary outcomes included pain interference (BPI9) and Medical Outcomes Study Short-Form 36 (SF-36v2). Primary and secondary outcomes were assessed at the end of treatment (EOT) and 1 and 4 weeks after the EOT.

RESULTS:

All participants tolerated the treatment well with 96% compliance. All leads remained infection-free and were removed intact at the EOT. On average, participants exhibited 70% reduction in BPI3 at the EOT and 61% reduction at 4 weeks after the EOT. All participants satisfied the success criterion of at least a 2-point reduction in BPI3 at the EOT. Longitudinal analysis revealed significant treatment effect for BPI3 (F = 14.0, P < 0.001), BPI9 (F = 5.9, P < 0.01), and the bodily pain domain of SF-36v2 (F = 12.8, P < 0.001).

CONCLUSION:

This case series demonstrates the feasibility of a single-lead, 3-week IMN therapy for the treatment of chronic HSP. Additional studies are needed to further demonstrate safety, efficacy, and long-term benefit, define optimal prescriptive parameters and dose, and expand clinical indications.

• Authors: John Chae, Richard D Wilson, Maria E Bennett, Tina E Lechman, Kathryn W Stager
• Journal: Pain practice : the official journal of World Institute of Pain (Pain Pract) Vol. 13 Issue 1 Pg. 59-67 (Jan 2013) ISSN: 1533-2500 [Electronic] United States
• PMID: 22448759 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2012 The Authors. Pain Practice © 2012 World Institute of Pain.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Adult
• Analysis of Variance
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Electric Stimulation Therapy (methods)
• Female
• Follow-Up Studies
• Hemiplegia (etiology, therapy)
• Humans
• Male
• Middle Aged
• Pain Measurement
• Peripheral Nerves (physiology)
• Shoulder Pain (etiology, therapy)
• Stroke (complications)